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      Análise crítica do uso do índice de massa corporal para idosos Translated title: Critical analysis of the use of the body mass index for the elderly

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          Abstract

          Esta comunicação discute a utilização do índice de massa corporal, suas limitações e aplicações na avaliação do estado nutricional de idosos. Há um consenso entre os pesquisadores de que um aumento no peso corporal em indivíduos de idade mais avançada seja aconselhável, mudando os pontos de corte até então utilizados. Atualmente, recomendam-se pontos de corte para definição de baixo peso (índice de massa corporal <22kg/m²), eutrofia (índice de massa corporal entre 22 a 27kg/m²) e sobrepeso (índice de massa corporal >27kg/m²) que diferem dos valores recomendados para adultos e freqüentemente utilizados para idosos. Esta proposta leva em consideração as mudanças na composição corporal que ocorrem com o envelhecimento. Apesar de não representar a composição corporal dos indivíduos, a facilidade de obtenção de dados de peso e estatura bem como sua boa correlação com morbidade e mortalidade justificam a utilização do índice de massa corporal em estudos epidemiológicos e na prática clínica desde que se usem pontos de corte específicos para a idade, especialmente se associados a outras medidas antropométricas que expressem a composição e a distribuição da gordura corporal.

          Translated abstract

          This communication discusses the use of the body mass index, its limitations and applications in the assessment of the nutritional status of the elderly. There is consensus between researchers that an increase in body weight in individuals of more advanced age is advisable, changing the cut-off points previously used. Currently, the cut-off points recommended for the definition of underweight (body mass index <22kg/m²), normal range (body mass index between 22 and 27kg/m²) and overweight (body mass index >27kg/m²), differ from the values recommended for adults and frequently used for the elderly. This proposal takes into consideration the changes in body composition that occur with aging. Although not representing the individual's body composition, the ease of obtaining weight and height data, as well as their good correlation with morbidity and mortality, justify the use of the body mass index in epidemiological studies and in clinical practice if age-specific cut-off values are used, especially if associated with other anthropometric measurements that express the composition and distribution of body fat.

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          Screening for nutritional status in the elderly.

          A comprehensive assessment of nutritional status is a critically important component of any patient evaluation. Based upon clinical information, anthropometric data, and a small number of laboratory investigations, an accurate appraisal of nutritional status should be possible and an appropriate intervention plan can be developed. The actual approach depends on the particular problem discovered. These are discussed in detail elsewhere in this issue.
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            The effect of sex, age and race on estimating percentage body fat from body mass index: The Heritage Family Study.

            To study the effects of sex, age and race on the relation between body mass index (BMI) and measured percent body fat (%fat). Cross-sectional validation study of sedentary individuals. The Heritage Family Study cohort of 665 black and white men and women who ranged in age from 17 to 65 y. Body density determined from hydrostatic weighing. Percentage body fat determined with gender and race-specific, two-compartment models. BMI determined from height and weight, and sex and race in dummy coded form. Polynomial regression showed that the relationship between %fat and BMI was quadratic for both men and women. A natural log transformation of BMI adjusted for the non-linearity. Test for homogeneity of log transformed BMI and gender showed that the male-female slopes were within random variance, but the intercepts differed. For the same BMI, the %fat of females was 10.4% higher than that of males. General linear models analysis of the women's data showed that age, race and race-by-BMI interaction were independently related to %fat. The same analysis applied to the men's data showed that %fat was not just a function of BMI, but also age and age-by-BMI interaction. Multiple regression analyses provided models that defined the bias. These data and results published in the literature show that BMI and %fat relationship are not independent of age and gender. These data showed a race effect for women, but not men. The failure to adjust for these sources of bias resulted in substantial differences in the proportion of subjects defined as obese by measured %fat.
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              Methods for the assessment of human body composition: traditional and new.

              Renewed interest in the assessment of human body composition has stimulated the need for a balanced understanding of available methodologies of estimating fat-free mass and percent body fat. This review summarizes the physical bases and assumptions, describes applications, and discusses the theoretical and practical limitations of currently available indirect methods. Although standard methods are discussed, recent modifications and adaptations are emphasized.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rn
                Revista de Nutrição
                Rev. Nutr.
                Pontifícia Universidade Católica de Campinas (Campinas )
                1678-9865
                December 2005
                : 18
                : 6
                : 765-775
                Affiliations
                [1 ] Universidade Federal de Viçosa Brazil
                [2 ] Universidade Regional do Noroeste do Estado do Rio Grande do Sul Brazil
                [3 ] Universidade Federal de Viçosa Brazil
                Article
                S1415-52732005000600007
                10.1590/S1415-52732005000600007
                09c97f65-45e6-4aea-a373-43b20f7ecfc4

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1415-5273&lng=en
                Categories
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                anthropometry,nutritional status,aged,body mass index,mortality,antropometria,estado nutricional,idoso,índice de massa corporal,mortalidade

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